11 Dec 2019

Meeting Emerging Nutrition Data Needs in DHS-8

Nutrition is central to the health, well-being, and economic development of individuals, communities, and nations. Comprehensive and credible data are needed to capture the current state of nutrition and track the implementation of nutrition interventions. The DHS Program is a leading source of nutrition data in low and middle-income countries.

The DHS Program has standard Model Questionnaires, updated every 5 years, which form the basis for the data that are collected in each country. In 2019, we underwent a rigorous process to update the questionnaires for DHS-8. A total of 89 nutrition-related questions are now in the Woman’s Questionnaire, up from 54 questions in DHS-7.

The DHS-8 questionnaires meet several current and emerging nutrition data needs which can be used to track progress and inform national and global decisions on nutrition policies and programs. This week we are highlighting the new and revised nutrition questions in DHS-8.

These new and revised questions strengthen the nutrition portfolio in DHS surveys, filling major data gaps and enhancing countries’ ability to address malnutrition in all its forms.

Click the icon below to view the new nutrition information by topic:

Anthropometry Measurement
Nutrition Counseling
Food or Cash Assistance
Iron Supplementation
Minimum Dietary Diversity for Women
Unhealthy Foods for Children
Growth Monitoring
FIES

Click the life cycle below to view all nutrition data collected in DHS surveys:

When will updated nutrition data be available?

The DHS-8 Model Questionnaires will be ready for use in surveys with fieldwork starting in late 2020 with data released starting in late 2021. In the meantime, The DHS Program will:

  • Translate the questionnaires
  • Revise training manuals and materials
  • Develop an adaptation guide for questions which require country-specific adaptation, such as infant and young child feeding and minimum dietary diversity for women
  • Create data processing applications
  • Define indicators, design table templates, and draft report templates
  • Pilot select new questions, modules, and alternative approaches for entering data in CAPI

The status of DHS surveys can be found here.


Visit The DHS Program website and subscribe to The DHS Program Nutrition eNewsletter for more nutrition updates in The DHS Program. You can also join the Data for Nutrition Community of Practice as a free, online platform for more nutrition resources.

Featured Image: © 2017 Riccardo Gangale, USAID, Courtesy of Photoshare.

 

Written by The DHS Program

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✴ New
♲ Revised

Women of reproductive
age and pregnancy

  • Anemia testing
  • Anthropometry measurement
  • Clothing and hairstyle interference withanthropometric
    measurements ✴
  • Coverage of breastfeeding counseling during antenatal care ✴
  • Coverage of nutritional counseling during pregnancy ✴
  • Cash-assistance programs for pregnant women ✴
  • Household salt iodization ♲
  • Deworming medication during pregnancy
  • Iron-containing supplement consumption during pregnancy ♲
  • Source for iron-containing supplements taken during pregnancy ✴
  • Minimum dietary diversity for women ✴

Infants

  • Anthropometry measurement
  • Clothing and hairstyle interference with anthropometric
    measurements ✴
  • Size at birth
  • Skin-to-skin contact, including timing of skin-to-skin contact ♲
  • Weighed at birth
  • Early initiation of breastfeeding
  • Exclusive breastfeeding
  • Bottle feeding
  • Introduction of any liquids or foods in the first three days
  • Postnatal breastfeeding counseling and observation ♲
  • Coverage of breastfeeding counseling during postnatal care
  • Feeding liquids during recent diarrheal episode
  • Feeding foods during recent diarrheal episode
  • Zinc treatment for diarrhea for children

Young children

  • Anemia testing
  • Anthropometry measurement
  • Clothing and hairstyle interference with anthropometric
    measurements ✴
  • Complementary feeding, including sugary drinks and
    unhealthy foods ✴ ♲
  • Coverage of nutrition counseling for infants ✴
  • Coverage of growth monitoring for children ✴
  • Deworming medication for children
  • Iron-containing supplements for children ♲
  • Vitamin A supplements for children
  • Zinc treatment for diarrhea for children
  • Feeding liquids during recent diarrheal episode
  • Feeding foods during recent diarrheal episode


Nutrition counseling is an important intervention during antenatal care, postnatally, and throughout early childhood. The Woman’s Questionnaire now includes questions on nutrition counseling during antenatal care, breastfeeding counseling during antenatal care, and nutrition counseling for young children. With this information, countries will be able to track the coverage and impact of nutrition counseling interventions. The reference period is 3 years to improve women’s recall and reduce survey burden.

Food or cash assistance programs for pregnant women are implemented in many countries around the world to improve maternal and child nutrition and other welfare outcomes. For the first time in the Woman’s Questionnaire, women will be asked to recall if they received food or cash assistance during pregnancy in the last 3 years.

Daily iron supplementation during pregnancy reduces the risk of maternal anemia and low birth weight and preterm births. The DHS survey already collects information on women’s consumption of iron supplements during pregnancy, but now the recall period has been reduced from 5 to 3 years. There is a new question about the source of iron supplements, so countries can understand where women access iron supplementation.

Information on iron-containing supplements for children is also collected in DHS surveys. This question has been updated to align with WHO guidelines on suggested schemes for iron delivery. The recall period has been increased from 7 days to the last 12 months, and the type of iron vehicle will now be recorded (i.e. multiple micronutrient powders or iron pills/syrups).

The Woman’s Questionnaire now includes Minimum Dietary Diversity for Women to assess the micronutrient adequacy of women’s diets and their intake of healthy and unhealthy foods. This fills an important data gap in women’s diet quality. Countries will be able to assess women’s diets at the national and sub-national levels and take appropriate action.

Given the global increase in overweight and obesity among children, the new questionnaire will collect information on unhealthy food and sugary drink consumption. These questions will help countries understand the extent of the problem and provide evidence to guide country programs and policies.

The Food Insecurity Experience Scale (FIES) is a standard measure of moderate and severe food insecurity. It is an indicator that countries use to measure their progress towards the Sustainable Development Goal of ending hunger (Target 2.1). There are plans to add the FIES as an optional module that countries can include in a DHS survey.

Growth monitoring for children is the second most common nutrition intervention reported by WHO member states. The Woman’s Questionnaire will now collect this information for comparable data at the national and sub-national levels.

Anthropometry measurement (height and weight) is a core component of DHS surveys that is used to generate indicators on nutritional status. The Biomarker Questionnaire now includes questions on clothing and hairstyle interference on measurements for both women and children for improved interpretation.